Esophageal Penetration of the Magnetic Sphincter Augmentation Device: History Repeats Itself
| Autor: | Renato Salvador, Mario Costantini, Stefano Merigliano, Lino Polese, Giovanni Capovilla |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Prosthesis Implantation Nissen fundoplication Esophageal Sphincter Lower Magnetic sphincter augmentation device 03 medical and health sciences 0302 clinical medicine Foreign-Body Migration Esophageal perforation medicine Humans Gastroesophageal reflux LINX Surgery Esophagus Laparoscopy Device Removal medicine.diagnostic_test business.industry Reflux Prostheses and Implants medicine.disease digestive system diseases Prosthesis Failure medicine.anatomical_structure 030220 oncology & carcinogenesis Magnets GERD Esophageal sphincter Sphincter Female 030211 gastroenterology & hepatology Deglutition Disorders business |
| Zdroj: | Journal of Laparoendoscopic & Advanced Surgical Techniques. 27:834-838 |
| ISSN: | 1557-9034 1092-6429 |
| Popis: | An alternative approach to the treatment of gastroesophageal reflux disease (GERD) has recently been introduced in clinical practice, involving the implantation of a magnetic sphincter augmentation device (MSAD). This "magnetic ring" is implanted laparoscopically around the lower esophageal sphincter to improve its barrier function. The literature is still limited on the midterm results achieved in controlling reflux because the MSAD is a very new procedure. So far, only a few cases of the MSAD causing erosion of the esophagus have been reported.We report on two cases of progressive and severe dysphagia after the implantation of an MSAD elsewhere. In both cases, the symptoms were caused by the migration of the device into the esophagus.The devices were removed endoscopically in a single step in both cases, using the Olympus cutter. After 3 months, the first patient had a laparoscopic Nissen fundoplication without any complications and with a good final reflux control. The second only underwent removal of the device, using the same endoscopic approach and again without any complications.Judging from the literature, MSAD implantation may be an effective way to control GERD, but the method can carry major complications, such as migration of the device into the esophagus (as in the two cases reported here). Endoscopic removal of a device possibly penetrating inside the esophagus is feasible and safe, and may later be followed up with a laparoscopic antireflux procedure without any particular difficulty. |
| Databáze: | OpenAIRE |
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